Obesity and Diabetes -- Contents -- Foreword -- Contributors -- 1 Changing epidemiology of obesity - implications for diabetes -- 1.1 Introduction -- 1.2 Assessment of obesity in epidemiological studies -- 1.3 Prevalence of obesity -- 1.4 The epidemiological link between obesity and diabetes -- 1.5 Factors modifying the relationship between obesity and diabetes -- 1.6 Early life influences on obesity and diabetes -- 1.7 Conclusions -- References -- 2 The genetics of human obesity -- 2.1 Introduction -- 2.2 Why has the genetics of obesity been difficult to study? -- 2.3 How much of obesity is genetic? -- 2.4 Is there a major gene for obesity? -- 2.5 How to identify obesity genes -- 2.6 Summary and conclusions -- References -- 3 Lifestyle determinants of obesity -- 3.1 The importance of energy balance -- 3.2 Physical activity -- 3.3 Energy intake -- 3.4 An integrated analysis -- 3.5 Conclusions -- References -- 4 Pathophysiology of obesityinduced T2DM -- 4.1 Introduction -- 4.2 Potential mechanisms linking central obesity to T2DM -- 4.3 Sources of increased plasma NEFA in obesity -- 4.4 'Randle's glucose-fatty acid' hypothesis -- 4.5 Ectopic fat storage hypothesis -- 4.6 'Oxidative stress' -- 4.7 The role of adipose tissue as an 'endocrine organ' in the pathogenesis of T2DM -- 4.8 Obesity as a low-grade inflammatory state -- 4.9 Summary -- References -- 5 Obesity and prevention of type 2 diabetes -- 5.1 Obesity and the risk of type 2 diabetes -- 5.2 Lifestyle intervention studies -- 5.3 Other intervention studies -- 5.4 Conclusions -- References -- 6 Diet and food-based therapies for obesity in diabetic patients -- 6.1 Introduction -- 6.2 Type 2 diabetes -- 6.3 Patterns of weight loss in diabetes -- 6.4 Target setting -- 6.5 Dietary and lifestyle alterations -- 6.6 Dietary nutrient composition in type 2 diabetes.

6.7 The approach to dietary prescription -- 6.8 Failure of therapy -- 6.9 Fat or carbohydrate -- 6.10 Meal replacement therapy -- 6.11 Very low calorie diets -- 6.12 Conclusions -- References -- 7 Behaviour change components of obesity treatment -- 7.1 Introduction -- 7.2 The 'toxic environment' -- 7.3 Motivational readiness -- 7.4 Patient expectations for treatment -- 7.5 Behavioural modification strategies in obesity treatment -- 7.6 Efficacy of combination treatments -- 7.7 Conclusions and future work -- References -- 8 Physical activity, obesity and type 2 diabetes -- 8.1 Introduction -- 8.2 Physical activity and exercise, what is the difference? -- 8.3 Current physical activity behaviour and guidelines -- 8.4 The importance of physical activity to health -- 8.5 Energy expenditure -- 8.6 Exercise tolerance and cardiorespiratory fitness in overweight and obese adults and children -- 8.7 Guidelines for exercise and activity prescription (including practical issues of clinical management for diabetics and the obese) -- 8.8 Research evidence on the role of physical activity in the prevention and treatment of obesity and type 2 diabetes -- 8.9 Physical activity and the behavioural treatment of obesity -- 8.10 Linking research and practice -- 8.11 Summary -- References -- 9 Diabetes, obesity and cardiovascular disease - therapeutic implications -- 9.1 Introduction -- 9.2 Obesity and mortality -- 9.3 Obesity and cardiovascular disease -- 9.4 Obesity and hypertension -- 9.5 Obesity and dyslipidaemia -- 9.6 Metabolic syndrome, obesity, type 2 diabetes and insulin resistance -- 9.7 Obesity and type 2 diabetes -- 9.8 Insulin resistance and cardiovascular disease -- 9.9 Type 2 diabetes and dyslipidaemia -- 9.10 Type 2 diabetes and hypertension -- 9.11 Type 2 diabetes and CHD -- 9.12 Benefits of weight loss -- 9.13 Management of hypertension.

9.14 Management of dyslipidaemia -- 9.15 Conclusions -- References -- 10 Drug therapy for the obese diabetic patient -- 10.1 Introduction -- 10.2 Drugs for hyperglycaemia -- 10.3 The role of anti-obesity drugs in diabetic management -- 10.4 Antihypertensive treatment -- 10.5 Use of other drugs that may cause weight gain -- References -- 11 The role of metabolic surgery in the management of type 2 diabetes -- 11.1 Introduction -- 11.2 Obesity and type 2 diabetes -- 11.3 Surgical techniques -- 11.4 Resolution of diabetes after bariatric surgery -- 11.5 How could surgery 'cure' diabetes? -- 11.6 Conclusions -- References -- 12 Childhood obesity and type 2 diabetes -- 12.1 Introduction -- 12.2 Childhood is a time of change -- 12.3 The problem of size -- 12.4 The size of the problem -- 12.5 What causes obesity in childhood? -- 12.6 Does obesity in childhood matter? -- 12.7 Management of childhood obesity -- 12.8 Management of T2DM -- 12.9 Conclusions -- References -- 13 Obesity and PCOS -- 13.1 Definition of the syndrome -- 13.2 Genetics of PCOS -- 13.3 Scope of the chapter -- 13.4 Pathogenetic mechanisms underlying the relationship between obesity and PCOS -- 13.5 Clinical features of obese PCOS women -- 13.6 Treatment of obese women with PCOS -- 13.7 Conclusions -- References -- 14 Management of diabesity in primary care: a multidisciplinary approach -- 14.1 Prevalence of obesity in primary care -- 14.2 Current approach to diabetes care in primary care -- 14.3 Early treatment with hypoglycaemic agents -- 14.4 Integrating obesity management with diabetes -- 14.5 A multidisciplinary approach -- 14.6 Dietary treatment of diabetes -- 14.7 Clinical assessment -- 14.8 Treatment groups -- 14.9 Physical activity -- 14.10 Behavioural change -- 14.11 Use of medication to aid weight loss in primary care -- 14.12 Summary -- References -- 15 Obesity and employment.

15.1 Introduction -- 15.2 Obesity, health and work -- 15.3 Effect of work on health -- 15.4 Shift work -- 15.5 Work and response to treatment -- 15.6 Effect of health on work -- 15.7 Sickness absence and short-term disability -- 15.8 Disability pensions -- 15.9 Is it reversible? -- 15.10 Accidents -- 15.11 Fitness for work and ergonomics -- 15.12 Medical standards -- 15.13 Rehabilitation -- 15.14 Stigma and discrimination -- 15.15 Health promotion -- References -- 16 Obesity in different ethnic groups -- 16.1 Introduction - obesity and adiposity -- 16.2 Prevalence of obesity and its relationship with metabolic risk in various ethnic sub-groups -- 16.3 Conclusion -- References -- Index.